Exploring online health seeking's potential via social search
Bonner, Matthew N.
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Online Health Seeking (OHS) is widespread and widely studied, but its ideal fit in healthcare is still unclear. OHS is seemingly emblematic of patient self-interest and control and is an intuitive fit with the tenets of patient-centered care (PCC). Researchers have made only a few attempts to evidence or leverage this connection, focusing instead on describing the figures and typical characteristics of OHS. Finding, consuming and sharing online health and wellness information is one of the common online activities, and consumers are generally satisfied with their results despite using simple and error-prone search strategies. Physicians are interested in their patients' OHS, but for a variety of constraints including time, compensation and traditional roles in medicine, most patient OHS goes unshared with doctors. Healthcare facilitators, a relatively new class of health professional that works to bridge the gap between their client's health and personal life, may be an ideal partner for patients in OHS. In this dissertation I share my investigation of the OHS-PCC connection, presenting a case study of a type of healthcare facilitator that has embraced OHS. By studying OHS, I was also able to contribute to the collaborative information seeking (CIS) community. CIS theory and social search tools have pointed to social factors that can influence the entire process of information seeking. In this dissertation I argue that nearly any social search design can be seen as situated or embedded in a unique socio-environmental context. I suggest that social search tools can be used as probes to understand the environment, and that interactions with a search tool can illustrate phenomena far beyond direct search motivations and goals. I also hypothesize that social search field studies can produce changes in their environment, producing changes in user relationships outside of the experimental search system. My study of OHS is an opportunity to test these hypotheses by creating a collaborative search tool that seeks to use OHS as a tool to improve patient-provider relationships. In this dissertation I present the results of a series of field studies at a local clinic that centers on a unique form of health facilitator. Drawing on several formative investigations and related work I synthesize design guidelines for a collaborative OHS tool and describe Snack, a collaborative search tool for OHS customized to my field site. I also present results from Snack's field study and an analysis of email messages between advisors and clients at the clinic. My results show that these health facilitators embraced OHS as a tool to guide and connect with their clients, but fell from this practice after a change at their clinic. After analyzing these results I discuss what makes health facilitators good OHS partners and cover implications for future OHS-based interventions. I also report the positive connections I found between OHS and other quality of care indicators like patient-centered care and the Multidimensional Health Locus of Control. Finally, I consider social search's utility as a probe and intervention in light of my results.